REHAB II Spinal Cord Injury

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Losdigity72
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264201
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REHAB II Spinal Cord Injury
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2014-02-28 12:58:28
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REHAB II Spinal Cord Injury
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REHAB II Spinal Cord Injury
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  1. What are the mechanisms of injury for SCI
    Flexion: head on collisions, blow to back of head, most common

    Compression: vertical/axial blow to head

    Hyperextension: posterior force (rear-end collision) falls in which chin strikes an object

    Flexion-rotation: posterior to anterior force on a rotated vertebral column
  2. What are some nontraumatic incidences of a SCI
    • thrombosis, embolus, hemorraghe
    • spinal vascular compromise (aneurysm)
    • infection (valley fever, syphilis, transverse myelitis)
    • spinal neoplasm,
    • subluxation casued by RA/DJD, spinal stenosis
  3. An absenjce of sensory or motor function in the lower sacral segments, absence of anal sphincter/sensation is what type of lesion
    Complete
  4. What is sacral sparing or S4-S5 sparing
    motor and/or sensory function below neurological level and has intact sensory and motor at S4-5
  5. Absence of motor and/or sensory function below neurological level with intact sensory and motor at S4-S5 (Sacral Sparing) is what type of lesion
    Incomplete
  6. Signs of motor and/or sensory function below the neurological level, but no function at S4-S5 is
    Zone of partial preservation
  7. This syndrome's signs consist of ipsilateral loss of motor & proprioception function and contralateral loss of pain and temperature sensation
    Brown Sequard Syndrome (Lateral Cord)
  8. A patient is suffering from loss of bilateral motor function, pain and temperature sensation below the lesion but still has bilateral position and vibration sense what syndrome is this patient most likely diagnosed with
    Anterior Cord Syndrome
  9. A spinal cord injury has affected the bilateral corticospinal and  spinothalamic tracts, what syndrome is most likely diagnosed
    Anterior Cord Syndrome
  10. An elderly patient presents with bilateral weakness in both UE and LE, but still has some cutaneous sensation what can be a possible cause of theses symptoms and what syndrome diagnosis is causing these symptoms
    Central cord syndrome

    cervical spondylosis, arthritis or stenosis
  11. This spinal cord syndrome which is most common and associated with hyperextension injuries such as a rear end collision
    Central Cord Syndrome
  12. A patient presents with both bilateral UE & LE weakness and paresis which affects the extremities more distally then proximal, which syndrome is this patient diagnosed with
    Central cord syndrome
  13. What is an early sign of central cord syndrome
    bilateral "burning hands" parasthesia
  14. This syndrome is chronic and progresses slowly and may be seen with cervical spondylosis a spinal cord cyst and in tumors of the cord
    Central Cord Syndrome
  15. A patient shows with atrophy of the gluteal, hamstring muscles, gastrocnemius and soleus due to greater muscle weakness of these muscles compared to the anterior leg muscles, what syndrome may cause this
    Cauda Equina Syndrome
  16. Cauda Equina Syndrome may be caused by
    • Lower motor neuron lesion
    • chronic disc herniation
    • spinal stenosis or tumors
  17. This syndrome will affect all sensory modalities in lumbar/sacral region, can produce severe radicular symptoms with minimal back pain, loss of tendon reflex in knee and ankle and can result in areflexia of bowel and bladder, which syndrome is this
    Cauda Equina Syndrome
  18. This syndrome is rare and affects the fasciculus gracilis and cuneatus  and is due to posterior spinal artery occlusion, chronic artheroscerosis impaired collateral circulation, tumors, disc compressing the posterior aspect of the spinal cord or vitamin B12 deficiency
    Posterior Cord Syndrome
  19. A transient areflexia period immediately following injury to spinal cord, which may last several days or weeks
    Spinal Shock
  20. A complete or partial lesion above T6 is diagnosed as
    Autonomic Dysreflexia (Hyperreflexia)
  21. This condition can present as HTN, bradycardia, severe headache, profuse diaphoresis, increased spasticity, restlessness, constricted pupils, nasal congestion, goose bumps, and blurred vision
    Atonomic Dysreflexia
  22. This occurs from a result from a disrupted balance between the sympathetic and parasympathetic input
    Orthostatic Hypertension
  23. PT interventions such as an abdominla binder, support hose, ace wrapping of LE, upright positioning in a gradual stages are all used for
    orthostatic hypertension
  24. Why is a patient educated to rely on sensory input from head and neck
    to assist with impaired temperature control
  25. What type of patients suffer from compromised respiratory function caused by decreased strength of abdominals (external obliques)
    tetraplegic and high level paraplegic
  26. What are the grades for the ASIA impairment scale
    • A = Complete
    • B = Sensory Incomplete
    • C = Motor Incomplete (more than half or more of key muscles below lesion have muscle grade of <3)
    • D = Motor Incomplete (at least half or more of key muscles below lesion have muscle grade of >3)
    • E = Normal
  27. Baclofen, tizanidine, diazepam, dantrolene sodium are medications used to treat what condition in SCI patients
    spasticity
  28. What are some secondary medical complications with a SCI
    • DVT, pressure sores
    • Pain (nociceptive, neuropathic)
    • heterotrophic ossification
    • contractures, fractures, osteoporosis
    • renal calculi, depression
  29. What are some PT interventions for a SCI patient
    • respiration/pulmonary activities
    • weightshifting-pressure relief
    • prescriptive wheelchair, w/c mobility
    • orthotic prescription
    • standing program & wt. supported treadmill trng
    • patient, family and caregiver education
    • ramp, car access, home eval/modifications
    • Mat program (ROM, bed mobility, sitting balance transfer trng.)

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